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  • Title: Methotrimeprazine versus meperidine and dimenhydrinate in the treatment of severe migraine: a randomized, controlled trial.
    Author: Stiell IG, Dufour DG, Moher D, Yen M, Beilby WJ, Smith NA.
    Journal: Ann Emerg Med; 1991 Nov; 20(11):1201-5. PubMed ID: 1952306.
    Abstract:
    STUDY OBJECTIVE: To compare the effectiveness of IM administration of methotrimeprazine, a non-narcotic, nonaddicting phenothiazine derivative, with that of a combination of meperidine and dimenhydrinate in the treatment of severe migraine. DESIGN: Double-blind, randomized, controlled trial. SETTING: University hospital emergency department. PARTICIPANTS: Consecutive adult patients with migraine who met eligibility criteria. INTERVENTIONS: Random allocation to receive IM injections of either 37.5 mg methotrimeprazine (Levoprome, Nozinan) or 75 mg meperidine (Demerol) combined with 50 mg dimenhydrinate (Dramamine, Gravol). MEASUREMENTS AND MAIN RESULTS: The 37 patients in each group who completed the study were similar in all demographic and clinical characteristics. There were no statistical differences in pain intensity one hour after treatment, change in pain intensity, or pain relief as measured on a visual-analog scale; need for additional analgesia; persistence of nausea or vomiting; adverse effects; or follow-up status, except for prolonged drowsiness, in the group receiving methotrimeprazine. CONCLUSION: Methotrimeprazine is comparable to meperidine with dimenhydrinate for treating severe migraine and may be considered an effective, nonaddicting, IM alternative to narcotics for the management of this problem.
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